From the Guidelines
Over-the-counter ear drops like carbamide peroxide (6.5%) are the most effective for ear wax removal, as they release oxygen that foams and breaks up the wax, making it easier to flush out. According to the clinical practice guideline update on earwax (cerumen impaction) published in 2017 1, topical therapy is commonly used to manage cerumen impactions, and water-based agents like carbamide peroxide have a cerumenolytic effect by inducing hydration and subsequent fragmentation of corneocytes within the cerumen.
To use these ear drops, apply 5-10 drops into the affected ear twice daily for 3-4 days. After each application, remain with your treated ear facing upward for 5-10 minutes to allow the solution to penetrate the wax. Alternatively, mineral oil, baby oil, or glycerin drops can be used to soften wax before removal. However, the mechanism by which nonoil-, nonwater-based eardrops manage cerumen has not been defined by in vitro studies, making carbamide peroxide a more reliable option 1.
After treatment, gently irrigate the ear with warm water using a bulb syringe. It is essential to note that if you experience ear pain, discharge, or if you have a history of ear drum perforation, ear tubes, or ear surgery, you should consult a healthcare provider before using any ear drops. Persistent ear wax problems may require professional removal by a healthcare provider. Despite the high incidence of cerumen impaction, there is a paucity of well-controlled and homogeneous studies of high quality on the efficacy of commonly used cerumenolytics, but carbamide peroxide remains a recommended option 1.
Key points to consider when using ear drops for cerumen imporation include:
- Using water-based agents like carbamide peroxide for their cerumenolytic effect
- Applying 5-10 drops into the affected ear twice daily for 3-4 days
- Avoiding usage if you have a history of ear drum perforation, ear tubes, or ear surgery
- Consulting a healthcare provider for persistent ear wax problems or if you experience any adverse effects.
From the FDA Drug Label
Directions FOR USE IN THE EAR ONLY adults and children over 12 years of age: • tilt head sideways • place 5 to 10 drops into ear • tip of applicator should not enter ear canal • keep drops in ear for several minutes by keeping head tilted or placing cotton in the ear • use twice daily for up to four days if needed, or as directed by a doctor • any wax remaining after treatment may be removed by gently flushing the ear with warm water, using a soft rubber bulb ear syringe Uses for occasional use as an aid to soften, loosen, and remove excessive earwax PRINCIPAL DISPLAY PANEL Relabeled by: Proficient Rx LP Thousand Oaks, CA 91320 Debrox® DROPSCarbamide Peroxide 6.5% Non USP*Earwax Removal AidKit includes soft rubber bulb ear syringe and drops½ FL OZ (15mL)
A good ear drop medication to alleviate cerumen (ear wax) impaction is carbamide peroxide (OTIC), as it is used to soften, loosen, and remove excessive earwax 2, 2, 2.
- The recommended use is to place 5 to 10 drops into the ear and keep the head tilted for several minutes, using it twice daily for up to four days if needed.
- Any remaining wax can be removed by gently flushing the ear with warm water, using a soft rubber bulb ear syringe.
- It is essential to follow the directions for use and consult a doctor for children under 12 years.
From the Research
Ear Drop Medications for Cerumen Imporation
- Ear drops can be used to remove or aid in the removal of ear wax in adults and children 3.
- The types of ear drops used to remove ear wax include:
- Oil-based compounds (e.g. olive or almond oil)
- Water-based compounds (e.g. sodium bicarbonate or water itself)
- A combination of the above or non-water, non-oil-based solutions (e.g. carbamide peroxide or glycerol) 3.
- A study found that active treatment with ear drops (e.g. triethanolamine polypeptide, almond oil, benzocaine, chlorobutanol) resulted in a higher proportion of ears with complete clearance of ear wax compared to no treatment 3.
- However, there is no evidence to show that one type of active treatment is more effective than another, or that oil-based treatments are superior to non-oil-based treatments 3.
- The use of saline or water alone as an ear drop does not appear to be better or worse than commercially produced cerumenolytics, and may not be better than no treatment at all 3.
- Adverse effects of ear drops, such as discomfort, irritation, or pain, were mild and reported in fewer than 30 participants across the studies 3.